Rumors have swirled recently that the Marshall County Free Clinic will be closing its doors soon, but the board says that’s not true.

The board met last week to discuss the future of the clinic.

“We’re still here, we’re still accepting patients, we’ll still see them,” said director Sharon Sirls.

It is true that the clinic’s number of patients has significantly decreased. Sirls said, “Our patient load has dropped 70 percent because of Obamacare.”

Although more Americans are insured, there are still some who fall through the cracks and need assistance from free clinics. But those clinics are struggling to keep their doors open to serve the people who still need them.

“We’re a free clinic but we still have bills that we have to pay: our electric, our phone, our Internet. We pay for all the labs that are done so we still have expenses,” Sirls said.

MCFC relies on donations from the community, but in a struggling economy and with fewer numbers of patients to serve, donations are more difficult to come by.

Sirls said, “We still have donations coming in, especially from the churches [who] have been marvelous in supporting us,” but the MCFC had to make some policy changes in an effort to keep the funding available for patients.

Daytime hours were previously offered on Monday, Tuesday and Wednesday. Now the office is only open on Mondays and Tuesdays.

In addition to these changes, Sirls said the office manager, Judy Richard, took the summer off without pay and that helps save money.

The Marshall County Free Clinic is not alone in its struggle with a changing healthcare landscape.

The office manager of Angels Community Clinic in Murray, Heather Glisson, said, “It’s hurting the people who are right in the middle.”

Glisson said she knows people who participate in kynect, Kentucky’s affordable care alternative, and are grateful to have coverage but struggle to afford the coverage costs along with living expenses.

She said that some plans require about $200 per month plus up to $18 copay per doctor visit. If a person with limited income has to see five doctors every month, that’s around $300 per month just for medical coverage and does not include the cost of living or the cost of medication.

Glisson noted many people still need help paying for their medication, which can cost up to $3,000 per month, because after paying for coverage and copays, there isn’t enough money left.

But ACC cannot help with those costs because the clinic only serves patients who do not have insurance.

Glisson said another problem the ACC faces is that some drug companies will offer assistance with the cost of medication only if the patient does not qualify for Medicaid. She said that if the drug company determines that a patient qualifies for Medicaid, even if the patient does not receive that assistance, the company will not send medication.

Betsy McClain of MCFC said that in addition to witnessing people struggle in the way that Glisson explained, there are still more who make tough choices.

McClain said that those who do not qualify for Medicaid but also cannot afford the coverage are required, per the Affordable Care Act, to pay a penalty fee for rejecting coverage.

The Individual Shared Responsibility Provision states that if a person does not have minimum essential coverage and was not granted an exemption, he or she must make an annual payment when filing the 2014 tax return in 2015.

According to www.irs.gov, the annual payment is the greater of 1 percent of household income that is above the tax return filing threshold for filing status or a flat amount of $95 per adult and $47.50 per child, limited to a family maximum of $285. These penalty amounts will grow with time.

In 2015, the income percentage increases to 2 percent of household income and the flat dollar amount increases to $325 per adult and $162.50 per child under 18.

In 2016, the income percentage increases to 2.5 percent of household income and the flat dollar amount increases to $695 per adult and $347.50 per child under 18.

After 2016, these increases will be determined by inflation.

In an effort to help ease financial worries and open the doors to more people, the MCFC board voted to change its Federal Poverty Guideline (FPG) standard.

The previous standard was 200 percent FPG, $22,980 for a one-income household. The new standard is 300 percent FPG, $34,470 for a one-income household.

“A lot of those people in that line right there are your single parents,” Sirls explained. She said these are the folks who work “career” minimum-wage jobs, and the folks who work two or three part-time jobs to reach full-time pay.

Board member Don Wilson said, “When we started this, we did not know what the Affordable Care Act would mean for us and we knew it could rearrange the whole landscape.”

The board is willing to continue to redirect and refocus efforts in such a way that allows the clinic to keep serving the community. Wilson said he wants anyone who needs help to call the clinic.

Sirls said MCFC has a screening process that takes about 30 minutes. Even if a person does not qualify for assistance from the clinic, MCFC personnel will assist in directing that person to the right place.

“We’re here to serve the public, we want to serve the public,” Sirls said.